There’s been a run of clients with sciatica recently – or at least clients who think they have sciatica.

For many, the issue appears to have been piriformis syndrome, also painful, with symptoms very similar to sciatica. Despite the similarity in symptoms, the underlying cause is different. But Bowen Therapy can help give relief to both…

So, what’s the difference ?

what is sciatica ?

Sciatica occurs when the sciatic nerve is irritated or pinched, sending sharp pains radiating down the line of the nerve. The sciatic nerve, the longest nerve in the body, starts at the spine in the lower lumbar area near the sacrum (L4/L5/S1). It runs through the buttocks and down the back of the leg, through hamstrings and calves.

Pinching or irritation of the sciatic nerve is caused by problems at the lumbar spine. An injury such as bulging or herniated disc, or joint inflammation, general wear and tear, or spine degeneration (such as arthritic changes or locked facet joints) in the lumbar region can all result in sciatic pain.

Pain can vary between aching or burning sensations to sharp shooting pains. It can also cause tingling, numbness or muscle weakness in the affected leg due to compression of the nerve. Sciatica is often felt in one leg only. Pain is often worse when sitting, and the sharp pain may make it difficult to stand up or walk.

It’s also sometimes seen in pregnancy if the position of the baby or shape of the uterus presses on the nerve.

and what is piriformis syndrome ?

Piriformis Syndrome is the result of the piriformis muscle being tight and going into spasm. It can also compress and irritate the sciatic nerve that the muscle crosses over (or sometimes the nerve passes through), causing similar pain to sciatic pain. For that reason, it’s also sometimes referred to as “false sciatica”.

The piriformis muscle is located deep in the buttock. It originates on the sacrum (at the end of the spine) and attaches to the top of the thigh bone. It’s a key muscle used when rotating the hip, and people impacted by piriformis syndrome may feel a reduced range of motion of the hip joint.

Pain from piriformis syndrome is often more localised in the hip and buttock, often deep inside the buttock muscles. You’ll know “THAT tender spot” in your buttock if your piriformis causes you grief. Pain may be aggravated by hip activity such as walking, especially up stairs or inclines, or prolonged sitting. The pain may feel better after lying down on your back.

Reasons the piriformis muscle may spasm may be related to dysfunction of sacro-iliac joints (SI joint) or hip joints, weakness of hip stability muscles (eg from too much sitting), or over-pronation when running or walking. The piriformis works to help prevent the knee from rotating too much – which can then lead to overuse and tightening of the muscle. It can often be a problem for walkers, runners or cyclists who use purely forward movement.

so, is sciatica or piriformis syndrome causing your pain ?

A couple of quick assessments can give you an idea…

Bowen Therapy can help

For a Bowen Practitioner, aligning and balancing the body in the lumbar and sacral region gives relief to many sufferers, whether they have sciatica or piriformis syndrome – and sometimes it can be surprisingly fast.

A recent client visited for a sore knee that prevented her walking up stairs. I could see that her pelvis wasn’t level and one foot was more turned out, so treatment involved balancing her lower body – lower back, pelvis, knees and ankles. When she returned a week later, she was in a level of disbelief – and not just because her knee now allowed her to run up stairs: “I didn’t even tell you that I had sciatica, but whatever you did – it’s gone !” (while I think that she had piriformis syndrome rather than true sciatica, it doesn’t really matter – a happy client)

A reminder – the assessments above are only a guide – only a doctor or physiotherapist/chiropractor/osteopath can give a proper diagnosis…

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[…] The risk for injury to ligaments of the back is increased. The risk for degenerated or bulging discs is increased. One of my clients with flat-back and suspected bulging discs, also experienced sciatic-like pain. […]